射频靶点热凝联合中药内服外敷治疗颈椎间盘突出症的临床研究

Clinical study on the treatment of cervical disc herniation with radiofrequency thermocoagulation and Chinese medicine

目的探讨射频靶点热凝联合中药内服外敷治疗颈椎间盘突出症的疗效及安全性。方法对116例经CT或MRI检查确诊的颈椎间盘突出症患者，按随机数字表法分为射频靶点热凝组56例（对照组）和射频靶点热凝联合中药组60例（治疗组）。对照组单纯行射频靶点热凝术治疗，治疗组采用射频靶点热凝术联合中药治疗。在治疗前、术后24h、术后1个月、术后3个月、术后6个月分别进行疼痛视觉模拟标尺法（VAS）、日本骨科协会（JOA）等评分以评价疗效。结果治疗前、术后24h的疼痛VAS、JOA评分组间比较差异无统计学意义（χ^2=0．19，P〉0．05），术后1个月、3个月、6个月的疼痛VAS、JOA评分组间比较差异有显著性（对照组F值分别为168．50、97．80、109．10，治疗组F值分别为286．50、165．34、75．82，P〈0．01）。两组治疗6个月后的疗效比较，对照组优良率为76．7％，治疗组为90．0％，两组优良率比较差异有统计学意义（χ^2=4．568，P〈0．05）。结论颈椎间盘突出症患者，采用射频靶点热凝联合中药内服外敷治疗颈椎间盘突出症有效。

Objective To explore the effects and security of traditional Chinese medicine combined with radiofrequency thermocoagnlation in the treatment of lumbar disc herniation. Methods A total of 116 cases with lumbar disc herniation were randomly divided into a treatment group and a control group. The control group （56 cases） was treated with radiofrequency thermocoagulation, while the treatment group （60 cases） was treated with Chinese medicine on the basis of the control group. Clinical effect was evaluated by VAS score and JOA score standard analysis before therapy, and 24 hours, 1 month, 3 month and 6 months after the therapy. Results There was no significant differences（χ^2=0.19, P〉0.05）in VAS and JOA score between the two groups before therapy and 24 hours after the therapy. While after 1 months, 3 months and 6 months after the therapy, there was significant difference between the two groups （F value of the control group was 168.50, 97.80. 109.10, F value of the treatment group was 286.50, 165.34, 75.82, P〈0.01）. The therapeutic effects comparison between the two group after 6 months therapy： the recovery rate was 76.7% and 90.0% in the control group and the treatment group respectively, showing significant differences （χ^2=4.568, P〈0.05）. Conclusion Chinese medicine combined with radiofrequency thermocoagulation was an effective method for cervical disc herniation.